Physiology of gastroesophageal reflux in the neonate.

Gastroesophageal reflux is physiologically normal in infants but can become gastroesophageal reflux disease when it leads to significant symptoms (persistent vomiting, weight loss, feeding difficulties). Gastroesophageal reflux disease is highly prevalent among infants and contributes to increased health care utilization. There are several physiologic and lifestyle factors that predispose infants to a higher degree of gastroesophageal reflux and disease related to it.

Familial polyposis syndrome and achalasia in a young adult.

We report the case of a 19-year-old White male diagnosed with familial adenomatous polyposis (FAP), Gardner's syndrome (GS) phenotype, status post total colectomy, who developed progressive dysphagia and weight loss. He was diagnosed with achalasia based on imaging and esophageal manometry. The patient underwent a Heller myotomy with the resolution of symptoms.

Ineffective esophageal motility: Characterization and outcomes across pediatric neurogastroenterology and motility centers in the United States.

Objectives: Ineffective esophageal motility (IEM) on high-resolution manometry (HRM) is not consistently associated with specific clinical syndromes or outcomes. We evaluated the prevalence, clinical features, management, and outcomes of pediatric IEM patients across the United States.

Methods: Clinical and manometric characteristics of children undergoing esophageal HRM during 2021-2022 were collected from 12 pediatric motility centers.

Novel Mutation in the Gene Causing Glucose-Galactose Malabsorption: First Confirmed Case From Central America.

Congenital glucose-galactose malabsorption is a rare cause of life-threatening diet-induced diarrhea in infants. Mutations in the gene, which encodes for the sodium-dependent glucose transporter, result in large-volume diarrhea due to aberrant glucose and galactose transport across the intestinal brush border. The diagnosis can be made clinically based on the presence of diarrhea soon after birth, evidence of carbohydrate malabsorption in the stool, and resolution of diarrhea with dietary elimination of glucose and galactose.

COVID-19 and the gastrointestinal tract in children.

Purpose Of Review: This is an overview of the effects of COVID-19 in the gastrointestinal tract in children, and current evidence of the impact of COVID-19 in pediatric patients with chronic gastrointestinal conditions, including inflammatory bowel disease (IBD), chronic liver disease, and disorders of the gut-brain interaction.

Recent Findings: Children with COVID-19 have a milder course and more favorable outcomes than adults, even in those with immunosuppression due to IBD or liver transplantation. Children with chronic gastrointestinal conditions do not have worse clinical outcomes than healthy children and infection itself has not been linked to an increased incidence of conditions such as IBD and celiac disease, but results regarding post-infectious irritable bowel syndrome are mixed.

Probiotics for treatment of chronic constipation in children.

Background: Functional constipation is defined as chronic constipation with no identifiable underlying cause. It is a significant cause of morbidity in children, accounting for up to 25% of visits to paediatric gastroenterologists. Probiotic preparations may sufficiently alter the gut microbiome and promote normal gut physiology in a way that helps relieve functional constipation.

A Versatile Human Intestinal Organoid-Derived Epithelial Monolayer Model for the Study of Enteric Pathogens.

Gastrointestinal infections cause significant morbidity and mortality worldwide. The complexity of human biology and limited insights into host-specific infection mechanisms are key barriers to current therapeutic development. Here, we demonstrate that two-dimensional epithelial monolayers derived from human intestinal organoids, combined with like bacterial culturing conditions, provide significant advancements for the study of enteropathogens.

Lymphoma in Pediatric-Onset Inflammatory Bowel Disease Treated with Infliximab Monotherapy: A Case Series.

Background: Inflammatory bowel diseases (IBD) are often treated with anti-tumor necrosis factor alpha (anti-TNFα) medications. Concomitant treatment of IBD with anti-TNFα agents and immunomodulators appears to be associated with an increased risk for lymphoma.

Methods: Patients who developed lymphoma while on monotherapy with an anti-TNFα agent were identified at three centers.

Utility of the Brussels Infant and Toddler Stool Scale (BITSS) and Bristol Stool Scale in non-toilet-trained children: A large comparative study.

Background: One of the criteria for functional constipation (FC) in Rome IV criteria is the presence of hard or painful bowel movements. In adults and children, the Rome IV criteria recommend the use of the Bristol Stool Scale (BSS). This scale is thought not to be appropriate for evaluation of stool consistency in young children.

The Great ESKAPE: Exploring the Crossroads of Bile and Antibiotic Resistance in Bacterial Pathogens.

Throughout the course of infection, many pathogens encounter bactericidal conditions that threaten the viability of the bacteria and impede the establishment of infection. Bile is one of the most innately bactericidal compounds present in humans, functioning to reduce the bacterial burden in the gastrointestinal tract while also aiding in digestion. It is becoming increasingly apparent that pathogens successfully resist the bactericidal conditions of bile, including bacteria that do not normally cause gastrointestinal infections.

Adherence Factor Expression in -Like Conditions.

The species are Gram-negative, facultative intracellular pathogens that invade the colonic epithelium and cause significant diarrheal disease. Despite extensive research on the pathogen, a comprehensive understanding of how initiates contact with epithelial cells remains unknown. maintains many of the same adherence gene operons; however, at least one critical gene component in each operon is currently annotated as a pseudogene in reference genomes.

Utility of Diagnostic Tests in Children With Functional Abdominal Pain Disorders.

Functional gastrointestinal disorders (FGIDs) and functional abdominal pain disorders (FAPDs) are common in pediatric patients. The prevalence of FGIDs using the Rome IV criteria ranges from 21.1% to 25.

Bacteriophage Therapy Testing Against Shigella flexneri in a Novel Human Intestinal Organoid-Derived Infection Model.

Objective: Enteric bacterial pathogens cause diarrheal disease and mortality at significant rates throughout the world, particularly in children younger than 5 years. Our ability to combat bacterial pathogens has been hindered by antibiotic resistance, a lack of effective vaccines, and accurate models of infection. With the renewed interest in bacteriophage therapy, we sought to use a novel human intestinal model to investigate the efficacy of a newly isolated bacteriophage against Shigella flexneri.

Gluten and Functional Abdominal Pain Disorders in Children.

In children, functional gastrointestinal disorders (FGIDs) are common at all ages. Consumption of certain foods, particularly gluten, is frequently associated with the development and persistence of FGIDs and functional abdominal pain disorders (FAPDs) in adults and children. However, this association is not well defined.

Intestinal P-glycoprotein exports endocannabinoids to prevent inflammation and maintain homeostasis.

Neutrophil influx into the intestinal lumen is a critical response to infectious agents, but is also associated with severe intestinal damage observed in idiopathic inflammatory bowel disease. The chemoattractant hepoxilin A3, an eicosanoid secreted from intestinal epithelial cells by the apically restricted efflux pump multidrug resistance protein 2 (MRP2), mediates this neutrophil influx. Information about a possible counterbalance pathway that could signal the lack of or resolution of an apical inflammatory signal, however, has yet to be described.

Recurrent Severe Iron Deficiency Anemia and Thrombocytopenia in an Adolescent Male.

An adolescent male presented with recurrent episodes over several years of severe iron deficiency anemia and associated severe thrombocytopenia. The anemia was secondary to chronic blood loss due to ulceration at the site of an ileocolonic anastomosis performed during infancy. We were able to demonstrate complete resolution of thrombocytopenia with the administration of iron, and without using steroids, intravenous immunoglobulin, or platelet transfusions.